Millions of people have smart phones, but smart heart implants are reserved for people with heart rhythm disorders and other cardiac conditions that put a person at risk for sudden cardiac arrest. These high-tech digital devices, called implantable cardioverter-defibrillators (ICDs), are pacemaker-defibrillators that go a step further than their earlier-generation cousins. Whereas older ICDs helped keep irregular heartbeats in synch or shocked an arrested heart back into action, the newer ICDs do this and more: Using wireless technology and the Internet, they automatically send data about a person’s heart function directly to the doctor, without the patient doing anything.
Dr. George Crossley, MD, president of St. Thomas Heart at Baptist Hospital in Nashville, Tennessee, explains the benefits of using ICDs with telemetry. For one thing, he says, “People don’t like to come into the office. These devices are an important part of our trying to move healthcare into the home. It’s the idea of letting people stay at home and stay healthy.”
The newer ICDs transmit diagnostic data to a secure Internet server where the doctor can see the information. This eliminates routine office visits when nothing is wrong and also alerts the physician when a patient needs medical attention. Dr. Crossley led a major study of nearly 2,000 heart patients using FDA-approved ICDs on the market. The study, published in the Journal of the American College of Cardiology, showed that frequent, automatic data transmission dramatically reduced the time between a heart irregularity and treatment. The time between detection of a problem and an office visit was shortened from an average of 22 days to just over four days.
Older ICDs that lacked telemetry shocked the heart back into action when necessary, but the doctor wouldn’t know there had been a problem until the patient’s next routine office visit. “People can be stubborn and don’t always call us,” says Dr. Crossley. “If they’re busy, they think, OK, the defibrillator did its job.” However, if too much time elapses before medical attention, he says the heart may sustain further damage. The study showed that getting treatment so much sooner shortened hospital stays.
Over the past decade, ICDs have grown smarter and smarter. Patients still using the first telemetry ICDs send data at preset intervals. They hold a small wand over their chest; the wand is connected to a monitor plugged into a phone line, which transmits the data. The main advantage is the convenience of fewer office visits.
The latest generation ICDs have built-in Wi-Fi that transmits data from the patient’s ICD automatically and much more often. “This is where the real advance took place,” says Dr. Crossley, citing the case of atrial fibrillation (rapid, chaotic beating from the heart’s upper chambers) as an example. “We don’t want patients to get shocked for this,” he says. “We want them to get medical attention because rapid heart rate can ruin the heart over time. The goal is to get them into the office within 48 hours and put them on blood thinners.”
CONNECT THE DOTS
For further reading, see:
* “The CONNECT Trial,” Journal of the American College of Cardiology, Vol. 57, No. 10, 2011,” by George H. Crossley, MD, et al.
* New Tools for Helping Heart Patients, New York Times, June 21, 2010
* Your Heart’s Electrical System, National Heart Lung and Blood Institute.
For more heart-related Healthy Outlook Blog posts, check out, “An Early Warning System for Cardiac Arrest,” “Heart Rate Variability Monitors May Aid Stress Reduction,” and “New Treatment for Stubbornly High Blood Pressure.”
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